Provider Demographics
NPI:1609325612
Name:CONNECTIONS COUNSELING, LLC
Entity Type:Organization
Organization Name:CONNECTIONS COUNSELING, LLC
Other - Org Name:NINA MARTIN, LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-208-2911
Mailing Address - Street 1:847 W MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3455
Mailing Address - Country:US
Mailing Address - Phone:203-208-2911
Mailing Address - Fax:
Practice Address - Street 1:847 W MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3455
Practice Address - Country:US
Practice Address - Phone:203-208-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0044351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1041C0700XMedicaid